| NPI | 1780292318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9436050-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 9436050-4405) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-11-03 |